Where Every Penny Counts

Revenue Cycle Management

Are your earnings commensurate with time and effort?
The practice of healthcare is born out of compassion. Physicians never compromise on quality medical care for their patients. Physicians are open to embracing innovative practices in medical care that is continuously evolving. The values of physicians should be recognized and compensated adequately. Despite best efforts, the revenue of some of the physicians continues to be unimpressive. This needs course correction.

Disproportionate revenue may be due to internal issues such as:

  • Claims back log
  • Uncontested Denials
  • Unresolved Appeals
  • Uncollected Insurance & Patient Payments

Physicians may recover the unclaimed revenue that they are entitled to without further delay and without spending thousands of dollars to do it. All that we need is a workforce that understands the entire process of Revenue Cycle Management and that is efficient in realizing its objectives.

RCM

Revenue Cycle Management

Sharp Info Solutions specializes in simplifying the medical billing process for healthcare providers. To assist the medical fraternities concentrate on their core job of patient care, Sharp Info Solutions ventured into Revenue Cycle Management.

Any provider who has a business association with Sharp Info Solutions for Revenue cycle Management would annihilate inefficient billing and coding issues and would concentrate on patient care. Sharp Info strives to improve billing standards. Each biller in Sharp is an expert; having years of experience and stays connected with the Medical Billing community.

With Sharp Info Solutions managing your revenue cycle, you don’t have to worry about the following, which we will take care of:

  • Quality
  • Productivity
  • Manpower Scalability
  • Infrastructure Scalability
  • Human Resource related issues

Additionally, avail a cost advantage, 24 X 7 support and personalized attention.

We offer the following revenue cycle management services:

Enrollment and Credentialing:

We gather necessary credentialing data from physicians to add them to the practice. We create sustainable workflow to effectively manage credentialing information. Our process is far from flaws and an increasing amount of practice staff time is spent researching, responding and maintaining credentialing-related files for providers. In order to keep your office running smoothly, it’s vital to prioritize the credentialing process in your practice.

Eligibility and Benefits Verification:

Eligibility / Benefits verification is a critical process in overall revenue cycle management. Eligibility verification is an efficient way to eliminate denials. Our team runs through a standard and customized list of verification questions to confirm the patient’s eligibility and coverage for the services to be provided. We will be able to predict the outcome of the claim, even before it is submitted.

Demographics and Charge entry:

Charge entry is done electronically to shorten the revenue cycle days. Patient demographics and medical codes applied to charts are appropriately verified. Every claim is verified to reduce the chance of claim rejection. Fee schedule of our clients is taken into consideration and bills are raised accordingly.

Claims are submitted to clearing house to ensure 100% accuracy. Our billers apply multiple layers of quality checks before submission of claims. We ensure clean claims submission.

Medical Coding:

We offer flexible medical coding services helping our clients to reduce their denials and optimize their revenues. Our professional coders are well experienced in procedural and diagnostic coding. Our medical coding services are compliant with various guidelines and help our clients stay focused on their core activities. We clearly understand the liability issues associated with incorrect coding and we thrive on high quality delivery.

We assist our clients with their short-term and long-term coding assignments. We are well prepared to face the challenges related to transitions in coding, including that of ICD-10.

Payment posting:

Due to the sensitivity of payment posting process, accurate and efficient payment posting is inevitable for Physicians’ office. EOBs are not our bible. We thoroughly crosscheck the EOB’s and we verify it by adjudicating it ourselves. Our billers are known to be highly efficient and analytical in payment posting.

Their specialty lies in working on the most advanced electronic remittance scenarios such as:

  • Denials,
  • Underpayments,
  • Overpayments,
  • Multiple Adjustments,
  • Automatic Cross-over,
  • Secondary Remittance,
  • Reversals and more...

Before our biller closes the payment posting, they match patient payments accepted in the front-office to encounters entered in the back-office.

Denial Management & Appeals

Denials are an epidemic to the financial health of most practices, and they have a need to be treated well in order to get you financial success. Around 10% of the physician revenue is estimated to be lost due to lack of denial management.

Billers in Sharp Info Solutions are experts in denial management. We believe in ensuring we have very less denials in the first place, and we deal with them efficiently when we have them...

Analysis
The key to denial management is ANALYSIS. Once the root cause of a denial is figured out, correcting it and getting paid for it is not as difficult. The skill of a specialist is required to get the perfect analysis into the claim and Sharp Info is very good at it.
Appeals
Our Billers review most commonly denied claims, prioritizing them based on both volume and dollar value and file them in a timely manner.
Considering the cost of appealing claims both in terms of time and money, our billers have the wisdom to decide whether they must appeal. We know the fact that many practices lose great sums of income every year because they don't appeal denied claims.

Accounts Receivable Management:

Account receivable is the vital part of any business. Our experienced callers use various follow-up methodologies to ensure prompt payments. We get to talk to the right person and get the claims resolved amicably.

Accuracy of the claim and the time spent on retrieving the payment are key points in optimized revenue collections. Reducing AR aging and maximizing cash flow is our goal.

Our billers have spent years on AR management. They have great understanding of claim status that they sometimes don't even pick up the phone to follow up. They have the process knowledge at their fingertips!

Financial Management Reporting:

We customize reports according to our clients’ requirements. We present periodic financial reports and other reports that include information on claims filed, payments received, receivables and aging. We can also customize our services as per client’s requirements, if the client does not wish to outsource the complete RCM. Our billers can take care of end to end Medical Billing requirements and can also support whenever the practice is overloaded.

Quality Department

Quality process plays a vital role in ensuring that clean claims are being transmitted / forwarded to the Insurance carrier. Quality check is done based on internal guidelines and client specific guidelines regularly. Quality check is performed in all departments of Medical Billing by laying down rules for each department and thereby eliminating errors completely.

A dedicated audit team ensures that no error goes unnoticed. Feedback from the audit team, feedback using client surveys and regular updates are disseminated to the entire team during regular team meetings and through continuous education programs. At sharp, every single employee understands that "anything is negotiable but Quality."